Comparison of Immediate Changes in Cervical Range of Motion Following Cervical Extension and Downslip Mobilizations.

June 14, 2026 updated by: Kim Ennis, Missouri State University

Cervical Rotation Range of Motion Improvements Following Cervical Extension vs Downslip Mobilizations

The purpose of this study is to compare the efficacy seated cervical extension glides vs supine downslip glides, on both cervical rotation range of motion and patient comfort. Information gathered from this study may be used to help clinicians determine the most beneficial methods of cervical mobilizations as a rehabilitation tool.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Subjects were randomized to either the Downslips group or the Seated AP Extension Glide. Prior to and immediately after mobilization, bilateral cervical rotation range of motion measurements were taken in seated using the Cervical Range of Motion device (CROM) which has been shown to have good validity and reliability. The starting sides of both cervical spine mobilizations were chosen at the start of data collection. After that, both therapists alternated the side to begin the mobilization with each new subject. Each mobilization was performed 5x40" with a twenty second rest between. All five mobilizations are performed first on one side, then the contralateral side in the same manner, prior to the subject returning to the seated position for retesting of their cervical rotation range of motion with the CROM. The same researcher performed the CROM measurement pre- and post-mobilization rotational testing to reduce interrater error. Following the final CROM measurement, the subject was then asked to rate their perceived comfort with the technique using a modified Visual Analogue Scale, with 0 being no pain and 10 being the most uncomfortable.

The downslip mobilization is completed in supine, with the practitioner positioned at the patient's head. The practitioner places their second metacarpophalangeal joint of the mobilization hand on the articular pillar of C2 while the stabilizing hand is on the occiput allowing for motion to occur.

Mobilization will be in an direction that is caudal and dorsal towards the subject's contralateral hip for 5x40" with a 20" rest in between. The supine downslip mobilization will be performed by the same therapist bilaterally for all subjects; this therapist has more than thirteen years of clinical experience with advanced manual therapy training. The Seated AP Extension mobilization is completed with the subject(s) seated in the Frankfort neutral position. The therapist starts by palpating the articular pillar. The stabilizing hand is placed on C3's lamina, applying a force perpendicular to a line through the oribita to block the caudal segment. The therapist's mobilizing hand will be supinated so that their lateral 5th metacarpal is on the lamina of C2. The subject is then brought into extension and rotation to the C2-3 segment and a caudal-dorsal mobilization is applied respecting the cervical spines facet joint orientation of 45 degrees for 5x40" with a 20" rest in between. The Supine AP Extension mobilization will be performed by the same therapist bilaterally for all subjects; this therapist has more than thirteen years of clinical experience with advanced manual therapy training.

Study Type

Interventional

Enrollment (Estimated)

128

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Missouri
      • Springfield, Missouri, United States, 65810
        • Recruiting
        • Missouri State University - Physical Therapy Clinic
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • healthy individuals
  • 18-45 years of age.

Exclusion Criteria:

  • current or previous history of neck pain;
  • cervical spine instability;
  • history of cervical spine surgery;
  • neurological issues;
  • contraindications to mobilization including fractures, coagulation issues, and osteoporosis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Cervical Downslips
Other: Cervical Downslip Mobilization
Mobilization in supine on the C2-3 articular pillar in a direction that is caudal-medial-ventral.
Experimental: Cervical Extension Glides
Other: Seated Cervical Extension Glide
Mobilization of C2 on C3 in a direction that is dorsal, lateral, and caudal.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Cervical Range of Motion
Time Frame: Immediately following mobilization
Immediately following mobilization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Missouri State University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

June 12, 2026

Primary Completion (Estimated)

September 28, 2026

Study Completion (Estimated)

September 28, 2026

Study Registration Dates

First Submitted

June 11, 2026

First Submitted That Met QC Criteria

June 14, 2026

First Posted (Actual)

June 18, 2026

Study Record Updates

Last Update Posted (Actual)

June 18, 2026

Last Update Submitted That Met QC Criteria

June 14, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB-FY2026-122

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We will de-identify the individual participant data to share our primary outcome measurement of pre- and post-mobilization cervical range of motion.

IPD Sharing Time Frame

This information will be available until statistical analysis has been completed by October 2028.

IPD Sharing Access Criteria

Other faculty researchers including: Dalton Burke, Mike Rider, Brent Denny, Blaise Burgeois, Bob Salvatori, Hazel Anderson. They will be able to access it on a Dropbox folder that is private for anyone without access to the link.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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